Flashcards in anatomy and physiology of pregnancy Deck (44)
number of pregnancies carried past 20 weeks – not number of fetuses born & regardless of alive or stillborn
a woman who has been pregnant
a woman pregnant for the first time
a woman who has delivered one child past gestation of 20 weeks
a pregnant woman who has been pregnant before
a woman who has carried two or more pregnancies to 20 weeks or more
a woman who has never been and is not currently pregnant
a woman who has not completed a pregnancy with a fetus or fetuses who have reached 20 weeks or more
pregnancy that has reached 20 weeks of gestation but before completion of 37 weeks of gestation (20- 26.6 wks)
capacity to live outside uterus; about 22 to 25 weeks gestation are on the threshold of viability
These very premature infants are vulnerable to brain injury
Name the term weeks
Early Term- 37 0/7wk- 38 6/7wks
Full Term- 39 0/7wks- 40 6/7wks
Late Term-41 0/7wks- 41 6/7wks
Post Term- 42 0/7wks and beyond Term: pregnancy from beginning of week 38 of gestation to end of week 42 of gestation
Two digits. define
G – gravida – number of pregnancy
P – para- over 20 weeks
GTPAL stand for ?
Gravidity (# pregnancies)
Term (deliveries >37 wk)
Preterm (deliveries >20wk but <37wk)
Abortions (deliveries <20wks spontaneous or induced)
Tell me about pregnancy tests
Human chorionic gonadotropin (hCG) is earliest biochemical marker of pregnancy
Pregnancy tests based on recognition of hCG or β subunit of hCG
Can be detected in serum or urine as early as 7 to 8 days after ovulation
Enzyme-linked immunosorbent assay (ELISA)
testing is most popular method of testing for pregnancy
ELISA technology is the basis for most over-the-counter home pregnancy tests
Medication use, hormone based tumors, or improper collection may cause inaccurate results
Presumptive signs of pregnancy
Least indicative of pregnancy
Probable signs of pregnancy?
More reliable & more diagnostic, but not true diagnosis
Positive lab tests
Fetal outline felt by examiner
Positive signs of pregnancy
Ultrasound of fetus
Fetal heart tones by Doppler or ultrasound
Fetal movement felt by examiner
Cervix characteristics when uterine growth in pregnancy occurs
it becomes vascular and edematous
Goodell’s sign -Softening of cervix- throughout pregnancy to prepare for delivery
Chadwick sign- bluish hue of the cervix and vagina
Hegar Sign- Softening of the area between the cervix and body of the uterus
what secretes progesterone and estrogen during the first 12 weeks? and why
Maintains pregnancy until placenta formed & functioning
What happens to the vagina during the growth of the uterine during pregnancy?
Vagina purplish (and cervix)Increased vascularity of vagina
Increased acidity to resist bacteria
increased vaginal discharge - leukorrhea
What happens to the breast during the growth of the uterine during pregnancy?
and what do you educate?
Increase in size, vascularity
Feelings of fullness & tenderness as early as 6 weeks
Colostrum as early as 16 weeks
*** Education- Supportive bra;
Discuss value of breastfeeding
early; Reinforce self breast exam
What happens to the respiratory system during the growth of the uterine during pregnancy?
and what do you educate?
Shortness of breath
Diaphragm displaced upward
Lungs expand horizontally
Warm compresses, humidifier, position changes
What happens to the cardiovascular system during the growth of the uterine during pregnancy in regards to just blood volume?
Blood volume increases 1500 ml
1000 ml plasma
450 ml RBCs
Blood volume 25-40% greater than nonpregnant levels
Physiologic anemia: apparent decrease in hemoglobin & hematocrit
RBC production increases 30-33%
What happens to the cardiovascular system during the growth of the uterine during pregnancy in regards to blood cells?
and what do you educate?
Hemoglobin- less than 11.5 g/Dl or hematocrit less than 30% is considered anemia
WBCs -increase to 5000-12000/cubic mm.
Cardiac output increases – 30 – 50%
Increased Pulse (14-20-wk)
Increased Cardiac output
Decreased Blood Pressure (slight)- 1st trimester- 32wks Back to baseline in 3rd trimester
Supine hypotension syndrome
Lying supine obstructs blood return from extremities, decreases cardiac output, hypotension
** Education- Tilt; change positions slowly
What happens to the renal system with urinary output?
what about specific gravity?
urine output increases
What renal test do you do in pregnancies?
Creatinine clearance best test of renal function
Done on 24-hour urine sample
*** Education: Empty bladder completely; limit fluid intake in evening; avoid caffeine
What happens to gastrointestinal system during pregnancy?
HCG & progesterone increase
Glucose levels decrease
Heartburn due to displacement of stomach by uterus - pyrosis
Slowing of GI tract leads to constipation, flatulence, heartburnDecreased tone and motility GI- incr P4
Reflux; Heartburn (pyrosis)
Pica – cravings for non-food items such as clay, laundry starch, and ice
Ptyalism – excessive
What do you want to educate in pregnancy in regards to gastrointestinal systems?
Small frequent meals;
Separate liquids from solids
Eat crackers before getting out of bed
Avoid greasy, spicy foods or triggers